Total Marrow Irradiation with Helical Tomotherapy Along the Entire Patient's Axis: A Planning Technique to Merge Helical Dose Distributions Producing Uniform Dose in the Junction Region

Abstract

Total marrow irradiation (TMI) with helical tomotherapy (HT) represents a valid alternative to total body irradiation (TBI). Given the limitations in the travel ability of the HT couch, TMI treatment has to be split in two segments defined as upper body and lower body, with the latter referring to the lower limbs treated with feet first orientation. The aim of this work is to present a planning technique to (i) match the helical dose distributions of the upper and lower body treatment plans and (ii) allow to evaluate and further improve the dose homogeneity in the region of field junction.